From what I have read, my 6-year old son presents with all of the characteristics of Asperger's D/O, but his doctor said his MRI looked normal. Is that the end of the discussion? Is there any research about this, and do you think I should seek a second opinion?

He does not socialize easily, fixates on WWII action figures and has “meltdowns” over unannounced changes, such as going to a different restaurant than planned, etc.

Is there a (standardized) test other than an MRI that can test for and diagnose Asperger’s or Autism?

Signed me a really worried Mom

Dear Worried Mom,

It seems that your instincts are on target!

In a 2001 Yale University research project, (Robert Schultz, primary investigator) does support a “connection” between irregularities in the fusiform gyrus (which is the main facial area of the brain; expressions, etc.) with individuals diagnosed with Asperger’s and Autism. It is not stop/start unequivocal diagnostic tool for this diagnosis. The report states that, “We cannot know at this point whether this difference in brain organization and function is at the heart of the cause of autism and related disorders or whether it is merely a reflection of what happens to the brain during early development when a person has autism or Asperger Syndrome."

Primarily it is still a diagnosis that is subjectively determined with checklists submitted by parents and teachers, with physician findings.

What is known, or conjectured, is that in very early childhood these children are “different” and that exposure to typical formative experiences, while the brain is most malleable, are more limited than in the typical child. However, several research studies do support that early intervention, and the earlier the better, are significant in helping these children normalize their social skills and related cognitive processes.

Lois Grayson, in a presentation from Cardiff University (Wales, United Kingdom) provided the following information on assessing children with Autism and Asperger’s: (quoted directly)

Normal use of cognitive assessment tools is not useful for categorisation

Her report goes on to state that few standardized tools, currently in use have been empirically validated for Asperger’s or Autism, and that although behavioral measures are subjective, they often give the most information. In addition, age of diagnosis is crucial, and that late diagnosis may be too late for anything more than accommodating others (i.e. family members) to the individual’s idiosyncrasies.

So to answer your question, if Asperger’s is suspected, I think you are correct in seeking another, better-informed second opinion. You may want to investigate (ask other Moms, look on the Internet, etc.) which doctors they use, and you can ask on the phone, before you make the appointment, if the doctor specializes in atypical development, specifically Asperger’s and Autism.

Hope this helps. Be Brave!!

Susan

Susan N. Schriber Orloff, OTR/L is the author of the book. “Learning RE-Enabled” a guide for parents, teachers and therapists,(a National Education Association featured book) as well as the CEO/Exec. Director of Children’s Special Services, LLC an occupational therapy service for children with developmental and learning delays in Atlanta, GA. She can be reached through her website at www.childrens-services.com or at sorloffotr@aol.com.